Privileging and Licensing Specialist - Provider Relations - Nevada Health Centers, Inc.

Are you looking for a career to be a part of a great culture of support and growth? Then welcome you made it to the job posting for you!

The Provider Relations Privileging and Licensing Specialist supports all aspects of provider relations with clinical staff in a non-profit health care setting for designated business unit(s).

This is a full-time position can be located at any of our three hubs in Carson City, Las Vegas or Elko. The position offers a comprehensive benefits package with paid time off and paid holidays. Also offers a career progression plan and the opportunity to be a part of our great team! 

Desired Knowledge, Skills & Abilities:

• Excel and PowerPoint
• Working knowledge of DocuSign
• Working knowledge of basic computer file systems, naming conventions, and organization
• Ability to take direction and be well organized
• Ability to communicate in a courteous and professional manner
• Ability to work and interact effectively and positively with other staff members to build and to enhance teamwork in the clinics and overall NVHC organization
• Skill in communicating effectively, both in oral and written form, to individuals and groups
• Skill in accuracy and attention to detail
• Ability to maintain confidentiality of information
• Ability to solve practical problems and deal with a variety of variables
• Ability to understand and respond appropriately, effectively, and sensitively to special population groups as defined by race, ethnicity, language, age, sex,
• Ability to work and interact effectively and positively with all levels of staff to build and enhance teamwork in the clinics and in the overall NVHC organization
• Ability to address multiple priorities; manage time and complete work in a timely and accurate manner while under the pressure of meeting deadlines
• Ability to handle stressful situations appropriately
• Ability to work independently
• Problem solving
• Ability to come to logical conclusions
• Ability to work proactively and identify issues before they become problematic
• Demonstrated ability to maintain confidentiality

Requirements of the position: 

• Bachelor’s degree required
• Minimum of 3 to 5 years of credentialing and privileging experience or similar relevant experience required.

Responsibilities of the position: 

• Manages initial licensing for onboarding providers and tracks approvals for various boards per requirements by role
• Manages Medicare/Medicaid revalidations for NVHC providers
• Manages and maintains compliant credentialing and privileging files for clinical staff as required by Health Resource and Service Administration (HRSA).
• Working in partnership with Human Resources:
• Monitors for new clinical hires,
• Partners with Human Resources for gathering of required paperwork and information for credentialing files,
• Partners with Human Resources for ongoing credentialing paperwork needs
• Partners with Human Resources for onboarding of providers
• Manages queries of state and national websites to verify eligibility for employment, licenses, certifications, and/or registration
• Manages queries of national websites to ensure that NPDB and OIG queries are completed and reviewed prior to employment of clinical staff, reports any findings to the Provider Relations manager in a timely fashion
• Maintains knowledge of HRSA regulations and changes in compliance
• Monitors licensure end dates and processes renewals ensuring that renewals are reported out to required partners
• Monitors new hires for training completion and ensures that training documentation is complete, signed, and part of the employee’s credentialing file
• Works with clinical leadership to obtain documentation of competency and fitness for duty
• Gathers materials and prepares credentialing files for initial privileging
• Manages reappointment processes, monitors expiration dates and ensures that reappointments are completed in a timely manner
• Works with clinical staff members to request necessary documentation and to compile reappointment requests
• Answers staff questions related to credentialing and privileging
• Management of CME requests and tracking of CME costs and requirements and completes enrollments into requested CME courses
• Management of the purchase and tracking of provider subscriptions and memberships
• Manages the student process and onboarding/offboarding of students in structured shadowing programs
• Manages initial enrollments into Medicare and Medicaid for providers
• Manages initial and ongoing CAQH management for providers
• Manages IT requests for onboarding providers
• Onboarding and credentialing of residents
• Set up and ongoing management of provider Medicaid portals
• Management and tracking of hospital privileging for privileged providers
• Management of extended coverage of provider mailboxes
• Partners with credentialing partners to submit providers for initial enrollments as well as re-credentialing needs
• Provides feedback on processes and participates in process improvement within the Provider Relations team
• Performs other work-related duties as requested by supervisor
• Complies with all aspects of the Standards of Behavior
• Supports the Provider Relations team as needed

About our company:

Established in 1977, Nevada Health Centers is the largest provider of primary care for the uninsured, underinsured, and geographically isolated, with 17 health centers, three mobile health programs, and seven Women, Infants, and Children offices. Our mission: To provide access to quality healthcare services throughout Nevada. Our vision: To create an integrated, provider-led healthcare system that supports the delivery of safe, effective, quality-based primary care to all Nevadans.

Nevada Health Centers will provide equal opportunity employment to all employees and applicants for employment. No person shall be discriminated against in employment because of race, color, gender, age, national origin, ancestry, religion, physical or intellectual disability marital status, parental status, sexual orientation or any other category protected by law.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee is occasionally required to stand; walk; stoop, kneel, or crouch. The employee must regularly lift and/or move up to 20 pounds.